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Saturday, December 19, 2009

Flummoxed AND stumped

Although it's better than it was, Fred and I are still up two to three times a night checking Elise. We are seeing some seriously WEIRD numbers.

The one that has us stumped during the day is her post-nap number. She is waking up in the low to mid-300s. We can't tell if we're missing a low while she's asleep, or her morning N needs to be increased. For example, to day she was 184 right before her nap at 1:00pm. It took her awhile to go to sleep, and when she woke up at 3:30, she was 304.

I think the only way we'll be able to figure it out is with a CGM, but I don't know if insurance will cover it or how expensive they are (or even if Elise will tolerate such a thing).

We've also been giving her DH(only 1.5 - 2 units) with her bed time N shot because we're having trouble getting her down after dinner. She's high going into it, and no matter how much DH we give her for her dinner time shot, she ends up at almost the same number three hours later. So tonight she was 315 at dinner, we gave her 14 units of DH (4 units more than she usually gets), and exactly three hours later, she's at 335.

I HATE giving her DH at bed time, because it's so scary for us to let her go to sleep with rapid-acting in her system.

Can anyone offer any insight from their experiences? I know it's hard to tell just by what I've written out here, but I'd welcome any advice. I think an email directly to the endo is in order on Monday if we can't figure it out before then.

8 comments:

  1. I think maybe she's just growing…I know you’re probably tired of that excuse and it’s not much help!
    I really don't think you're missing a low at nap time though the 180's is more than enough to hold her over for an hour or 2, strange idea but do you think she could be having weird dreams that get her adrenaline going and in return raise her blood sugar?

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  2. Does she hava a snack right before her nap? If she does, maybe it needs to be covered. I hope your doc can help you. If she is growing, she may need more insulin at certain times of the day. I know my boys need more from 1:00pm to bedtime for some reason.

    I wish I could help more. :(

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  3. Also, I don't remember...how long does NPH stay in her system? Could it be out by 3:00 in the afternoon? Could it be out by the time she gets up and that is why she wakes up higher in the morning just a couple hours after you test her? I ALMOST remember having to give J his NPH at 10:00 so it would last until morning.

    How can I not remember all of this? I feel brain dead. Does it help you to know that someday you won't remember all of this madness?

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  4. well meri said what I was going to say and yes like meri said it helps to know that you wont remember all of this someday anyway.

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  5. @ AJsMommy82 - I'm pretty sure she just went through a growth spurt, and I guess we could be seeing the effects of it. I never thought of the dream thing... has anybody ever heard of this happening?

    @ Meri - Elise naps about 30 minutes after her lunch. With the NPH, we find if we give it to her by 8:30 am, it peaks around noon, and then we get another "mini-peak" around 3:00, which was why I was worried about her going low during her nap. I also keep flashing back to the other day when she woke up from her nap with a BG of 39.

    @ phonelady - thanks and I hope you're feeling better soon!

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  6. I wish I could offer some help...we weren't on NPH very long.

    I know you're not interested in the pump right now...but that really seemed to help when Addy was in a number frenzy -- number frenzies still happen, but I find it easier to tweak her settings because I can fine tune each 30 min segment of the day...as opposed to the same dose for a long period of time.

    I was quite surprised to learn how different Addy's insulin needs actually are throughout the day. Not only her basals, but her corrections and ratios too.

    If she were waking up from her nap high at 3 pm, I'd go back to her basal at 1 pm and increase it a tad.

    Sorry I can't be more helpful :(

    Just remember that you're doing a great job! Keep up the good work and stay strong, SISTA!!!!!

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  7. When Addison is growing we see seriously weird numbers too. I can't really comment on NPH since we use lantus but I can say that we when we see weird numbers we track them for 3 days and if they seem to show a "regular" pattern we make an adjustment. Maybe her before nap DH insulin to carb ratio needs to be upped a little bit ? If you try that and it doesn't work maybe then you can try adjusting the NPH? I am sorry you are having such a hard time lately!

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  8. @ Wendy - Yeah, the pump is becoming more and more attractive lately. Still not sure I'm ready for it though.

    @ Jen - Because Elise is on NPH, she doesn't get a lunchtime shot. We'll probably need to up her morning N to combat these highs (but I'm still not convinced she's not going low during her nap).

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